厄贝沙坦对慢性充血性心力衰竭血清脂联素浓度的影响

目的观察血管紧张素受体拮抗剂厄贝沙坦对慢性充血性心力衰竭（CHF）病人血清脂联素浓度的影响。方法临床选择CHF病人69例,随机分为CHF对照组（38例）和CHF治疗组（31例）。CHF对照组和CHF治疗组均给予地高辛、利尿剂、硝酸甘油等常规治疗6个月,CHF治疗组除常规治疗外还加服厄贝沙坦片（150mg/日）连续6个月。所有研究对象均在治疗前后测定心脏左室舒张末内径（LVEDD）、左室射血分数（LVEF）、血清脑钠素（BNP）和脂联素水平。结果 （1）CHF对照组和CHF治疗组病人治疗前的BNP与脂联素水平成正相关（R=0.36,P〈0.05）。（2）与治疗前对比,CHF对照组和CHF治疗组病人经过6个月的治疗后,LVEDD均无明显改变（P〉0.05）,但是两组LVEF有显著改善（P〈0.05）,血清BNP和脂联素水平均降低（P〈0.05）。（3）治疗6个月后,CHF治疗组LVEF、血清BNP和脂联素水平与CHF对照组对比有明显差异（P〈0.05）。结论厄贝沙坦可以升高CHF患者血清脂联素水平,从而进一步改善CHF病人的心功能。

The effect of irbesartan on serum concentration of adiponectin in patients with chronic heart failure

Aim To observe the effect of irbesartan on serum concentration of adiponectin（APN） in patients with chronic heart failure（CHF）.Methods There 69 cases were divided into CHF control group consisted of 38 cases and CHF treatment group consisted of 31.Patients in the CHF control group were given conventional medicine treatment such as digoxin、diuretics、nitrates and so on.Patients in the CHF treatment group were given orally irbesartan（150mg/day）for six months besides conventional medicine treatment.Left ventricular end-diastolic diameter（LVEDD）,left ventricular ejection fraction（LVEF）,serum brain natriuretic peptide（BNP）and APN were evaluated in all cases before and after treatment.Results（1）APN was positively correlated（r= 0.36,P0.05）with BNP in CHF patients before treatment both.in the CHF control group and the CHF treatment group.（2）.The LVEDD was not changed six months after treatment.However,LVEF were improved（P0.05）,BNP and APN were significantly decreased（P0.05）six months after treatment compared with that before treatment.（3） the levels of LVEF、BNP and APN were signficantly different in the CHF treatment group compared to those in the CHF control group（P0.05）.Conclusion Irbesartan can lower serum concentration of APN,and improve heart function.